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Water-enema multidetector computed tomography for planning surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Water-enema multidetector computed tomography (WE-MDCT) is a technique for the localization and preoperative T- and N-stage assessments of colon cancer. It may be a useful tool for planning surgery. The primary aim of this study was to evaluate the diagnostic accuracy of WE-MDCT for T-staging and its ability to locate tumors for laparoscopy planning. The secondary aim was to assess reading reproducibility and diagnostic accuracy for the preoperative determination of N-stage.

Methods

We performed a study to evaluate preoperative WE-MDCT for surgical planning in patients with symptomatic colon adenocarcinomas who underwent surgery between June 2010 and January 2014. A radiologist and a surgeon read the WE-MDCTs separately. Results were compared with colonoscopy and the surgical specimen.

Results

Seventy-one patients (42 men (59.1 %); mean age 73.1 years (range 45 to 95)) were included. Seventy-six tumors were assessed. The intraclass correlation coefficient (ICC) for location as determined by surgery and that determined by WE-MDCT was 1, and the ICC for location between colonoscopy and WE-MDCT was 0.85 (95 % CI 0.75–0.91).

For T-stage determination, sensitivity was 96 and 94 % and specificity 83 and 88 % for readers 1 and 2, respectively. The T-stage assessment allowed for the programing of surgical access and showed good sensitivity and specificity for the assessment of invasion in adjacent organs.

Conclusion

WE-MDCT is relatively easy to perform, and its results can be read effectively by radiologists and surgeons. WE-MDCT indicated the location of tumors perfectly and permitted a good determination of their T-stage. The technique is thus pertinent for the planning of laparoscopic surgery for colon cancer.

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Acknowledgments

The authors want to thank Mr Kevin Erwin for his kind help in the correction of the manuscript.

Conflict of interest

No conflicts of interest.

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Authors and Affiliations

  1. L’UNAM, University of Angers, Angers, France

    A. Venara, L. Toque, E. Lermite, C. Aube & A. Hamy

  2. Department of Visceral Surgery, CHU Angers, 4 rue Larrey, 49933, Angers Cedex 9, France

    A. Venara, L. Toque, E. Lermite & A. Hamy

  3. Department of Medical Imaging, CHU Angers, Angers, France

    C. Ridereau-Zins & C. Aube

  4. Department of Hepato-Gastroenterology, CHU Angers, Angers, France

    E. Cesbron

  5. Department of Histopathology, CHU Angers, Angers, France

    S. Michalak

Authors
  1. A. Venara
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  2. C. Ridereau-Zins
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  3. L. Toque
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  4. E. Cesbron
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  7. C. Aube
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  8. A. Hamy
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Corresponding author

Correspondence to A. Venara.

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Venara, A., Ridereau-Zins, C., Toque, L. et al. Water-enema multidetector computed tomography for planning surgery. Int J Colorectal Dis 30, 691–696 (2015). https://doi.org/10.1007/s00384-015-2172-3

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  • DOI: https://doi.org/10.1007/s00384-015-2172-3

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